NYAPRS Note: The following piece a number of landmark advances that were included by NYS Governor Kathy Hochul in her recently released 2022-3 Executive Budget proposal, most notably the inclusion of a long promised COLA, a number of crisis and criminal justice reforms, a significant reinvestment of managed care savings into the behavioral health service sector and a proposal to reduce the number of state approved Medicaid health plans and to create a competitive bidding procurement process. See more about the budget at https://www.nyaprs.org/e-news-bulletins/2022/1/18/nyaprs-1st-look-at-hochul-budget-54-cola-retention-bonuses-988-hotline-w-more-crisis-services and the Medicaid Managed Care proposal at https://tinyurl.com/2p9csjc6. Great thanks once more to Governor Hochul for an extraordinary set of proposals!
New York MH Advocates Laud Investments In Proposed Budget
Mental Health Weekly January 31, 2022
New York state advocates and providers say they are pleased with the governor’s attentiveness to a long-overdue cost-of-living adjustment (COLA) increase, support of retention and recruitment of the health care workforce, and monitoring and enforcement of Medicaid managed care behavioral health services.
Gov. Kathy Hochul released her 2022-2023 executive budget proposal Jan. 18, which makes significant investments in the state’s workforce. It includes a 5.4% COLA…. for the mental health workforce, services and supports. Additionally, Hochul’s proposal supports growing the health care workforce by 20% over the next five years.
Regarding criminal justice reform, the budget proposes a pilot program to address a new approach to transitional housing for postincarceration individuals to secure suitable residences for parolees who otherwise might be released into the shelter system. It also calls for a restoration of the Tuition Assistance Program for incarcerated individuals. The program helps eligible New York residents pay tuition at approved schools in New York state. Additionally, the budget calls for the creation of an Office of the Chief Disability Officer to serve as an advocate with attention to the needs and rights of persons with disabilities.
“The governor’s budget is the best budget I’ve seen in a very long time — one of the best in 30 years of doing this job,” Harvey Rosenthal, CEO of the New York Association of Psychiatric Rehabilitation Services (NYAPRS), told MHW. The proposal is significant, he said. Agencies have been losing their workforce in droves for years, Rosenthal said.
“They gave us what we are asking for: 5.4% for COLA,” he said. Prior to this proposed increase, advocates had gone to many legislative sessions only to hear “broken promises” related to COLA increases, said Rosenthal. “The governor made good,” he said. “She is really paying attention to this and other areas.”
Other Supports
The governor also has plans to create a new Office of Health Equity, one that would be established within the Department of Health to set priorities, collect and disseminate data and align resources across state agencies to address health equity among “underserved populations,” he noted.
Rosenthal also pointed to Hochul’s Clean Slate Act legislation. New Yorkers convicted of felonies would be eligible to have their records sealed seven years after their release. Those sentenced for misdemeanors would be eligible to have their records sealed after three years. Their slate would be wiped clean, as long as they didn’t reoffend within the three or seven years after release, Rosenthal noted. “NYAPRS is in favor of this,” he said.
The budget proposal also includes support of the federal creation of the 988 crisis hotline and increased crisis services, strengthening suicide prevention and establishing safe options support teams. The latter initiative would involve the Office of Mental Health (OMH) partnering with New York City to reach homeless individuals living on the streets by establishing 20 new teams of mental health professionals performing Critical Time Intervention, an evidence based practice to help connect people to housing and services.
Enforcing MCO contract provisions
Over the last six or seven years since behavioral health services were carved into Medicaid managed care, the 105-member New York State Council for Community Behavioral Healthcare has focused on ensuring adequate access to care, Lauri Cole, executive director of the New York State Council for Community Behavioral Healthcare, told MHW. The Council sought and supported continuity of care and ensuring that the state conducted robust surveillance and enforcement of all various laws, regulations and contract provisions implemented when behavioral health services were carved in. Two years ago, the Council subsequently recognized that they hadn’t heard about the premiums the state paid managed care organizations (MCOs), she said. “We asked questions,” Cole said. “We received no answers.”
They sent Freedom of Information Act requests to the state Department of Health Services, Office of Addiction Services and Supports (OASAS), the OMH and the attorney general’s office about the MCO performances and its expenditure targets, she noted. The state, they found, had not enforced MCO contract provisions. “We began to advocate under [the former] Cuomo administration,” Cole said.
Hochul’s administration seeks to correct the issue of reinvestment of savings from the carve-in for two years, said Cole. The governor’s budget proposes to reinvest some $111 million (state share) with OASAS and the OMH. “With the federal match, the return on our work is $222 million!” noted Cole. “We are grateful to the Hochul administration for meeting with us and hearing our complaint knowing full well the problem had been created before the Hochul administration,” she said. “They heard us and sought to correct this problem in the executive budget. It’s really a big deal.”
Crain’s New York Business reported Jan. 25 that the new proposal completely reshapes the state Medicaid program by requiring health plans to compete for a limited number of managed care contracts covering millions of New Yorkers. Current and previously authorized Medicaid managed care providers in New York will have to go through the Request for Proposal process to continue operating their plans, and their past performance will be included in the state’s evaluation process.
The competitive bid process is the right step for New York, said Cole. “We are going to work hard to protect that proposal,” she said. Previously, providers had their whole staff “chasing reimbursement,” said Cole. There’s no doubt that such a move in the proposal would reduce administrative burdens on providers, Cole noted. “Providers will now be able to focus on providing care to meet increased demand,” she said.
Meanwhile, Cole plans to testify at the budget hearing and point out the importance of the competitive bid proposal and the importance of New York focusing more attention on surveillance, monitoring and enforcement of contract provisions related to the carve-in of behavioral health services into Medicaid managed care.